First and foremost, a radiologist is a physician who went to medical school to acquire a basic core of knowledge and skill. The basics include developing an effective level of dialogue with patients and performing a physical examination (which is oftentimes all that is necessary to diagnose and sometimes treat). Upon graduation from medical school, the budding radiologist then embarks upon a minimum 4-year period of specialty training (don’t need to bring a radio). In the old days, the training involved largely the interpretation of X-Ray pictures for broken bones, pneumonia and the like, with the X-Rays developed in Dark Rooms.
Well, let us fast forward 40 years. The Dark Rooms are gone. The physician radiologist still interprets pictures but they now include (but are not limited to) ultrasounds, CT scans, mammograms, MRI and PET scans. The radiologist also performs an ever increasing number of procedures such as biopsies of potential tumors located almost anywhere in the body, that are now accessible by virtue of ever more sophisticated imaging technology. In many cases, it is the radiologist who determines the cause of the patient’s ailment. Examples include diagnosing gallbladder attacks on ultrasound, appendicitis and kidney stones on CT scans, trauma to the brain and body organs on CT scans and cancer anywhere in the body including breast cancer on mammograms. Radiologists also treat an array of disorders including placing grafts or stents in major blood vessels such as in the heart and legs, draining abscesses and other collections of fluid in the body as well as draining blocked kidneys.
With the ever increasing use of imaging, legitimate questions have emerged regarding the safety of the imaging (i.e. radiation dose). Mission statements of all Radiological organizations such as the American College of Radiology (ACR) and the Radiological Society of North America (RSNA) address the paramount importance of imaging safely and effectively. Examples of initiatives include the Image Wisely campaign of the ACR, RSNA, ASRT ( American Society of Radiologic Technologists) and AAPM (American Association of Physicists in Medicine) and the Dose Index Registry created by the ACR. What can you, the patient. do? The answer is to ask your health care provider whether the imaging test is truly necessary for the diagnosis and management of your condition. If it is necessary (in many cases it is crucial), then rest assured that any imaging facility accredited by the ACR will have personnel and equipment that meet nationally-accepted standards, including with regard to safety guidelines.
The physician radiologist is but one of many important members of your healthcare team, none of whom is as important as you, the patient. As the “Captain of the Ship”, I encourage you to ask the necessary questions so that you will receive the best possible care.